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"Human growth"
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Why do I grow?
\"Want to know how bones, fingernails, and hair form and grow throughout our lives? Fun illustrations and entertaining text help give kids a clear understanding of how our bodies grow and change throughout our lives\"-- Provided by publisher.
BOOK
Weekly Lonapegsomatropin in Treatment–Naïve Children With Growth Hormone Deficiency: The Phase 3 heiGHt Trial
Abstract
Context
For children with growth hormone deficiency (GHD), treatment burden with daily somatropin injections [human growth hormone (hGH)] is high, which may lead to poor adherence and suboptimal overall treatment outcomes. Lonapegsomatropin (TransCon hGH) is an investigational long-acting, once-weekly prodrug for the treatment of GHD.
Objective
The objective of this study was to evaluate the efficacy and safety of once-weekly lonapegsomatropin vs daily somatropin.
Design
The heiGHt trial was a randomized, open-label, active-controlled, 52-week Phase 3 trial (NCT02781727).
Setting
This trial took place at 73 sites across 15 countries.
Patients
This trial enrolled and dosed 161 treatment-naïve, prepubertal patients with GHD.
Interventions
Patients were randomized 2:1 to receive lonapegsomatropin 0.24 mg hGH/kg/week or an equivalent weekly dose of somatropin delivered daily.
Main Outcome Measure
The primary end point was annualized height velocity (AHV) at week 52. Secondary efficacy end points included change from baseline in height SD scores (SDS).
Results
Least squares (LS) mean (SE) AHV at 52 weeks was 11.2 (0.2) cm/year for lonapegsomatropin vs 10.3 (0.3) cm/year for daily somatropin (P = 0.009), with lonapegsomatropin demonstrating both noninferiority and superiority over daily somatropin. LS mean (SE) height SDS increased from baseline to week 52 by 1.10 (0.04) vs 0.96 (0.05) in the weekly lonapegsomatropin vs daily somatropin groups (P = 0.01). Bone age/chronological age ratio, adverse events, tolerability, and immunogenicity were similar between groups.
Conclusions
The trial met its primary objective of noninferiority in AHV and further showed superiority of lonapegsomatropin compared to daily somatropin, with similar safety, in treatment-naïve children with GHD.
Journal Article
Methods in human growth research
This volume is a review of up-to-date methods used in human growth research.
Book
Cost-Effectiveness and Efficacy of a Novel Combination Regimen in Acromegaly: A Prospective, Randomized Trial
Abstract
Context
Combination therapy with somatostatin receptor ligand (SRL) plus pegvisomant for patients with acromegaly is recommended after a maximizing dose on monotherapy. Lower-dose combination regimens are not well studied.
Objective
To compare cost-effectiveness and efficacy of 3 lower-dose combination regimens in controlled and uncontrolled acromegaly
Design and Setting
Prospective, randomized, open-label, parallel arm study at a tertiary referral pituitary center.
Patients
Adults with acromegaly regardless of response to prior SRL and biochemical control status at baseline, stratified by an SRL dose required for insulin-like growth factor (IGF)-I normalization during any 3-month period within 12 months preceding enrollment.
Intervention
Combination therapy for 24 to 32 weeks on arm A, high-dose SRL (lanreotide 120 mg/octreotide long-acting release [LAR] 30 mg) plus weekly pegvisomant (40-160 mg/week); arm B, low-dose SRL (lanreotide 60 mg/octreotide LAR 10 mg) plus weekly pegvisomant; or arm C, low-dose SRL plus daily pegvisomant (15-60 mg/day)
Main Outcome Measure
Monthly treatment cost in each arm in participants completing ≥ 24 weeks of therapy.
Results
Sixty patients were enrolled and 52 were evaluable. Fifty of 52 (96%) demonstrated IGF-I control regardless of prior SRL responsiveness (arm A, 14/15 [93.3%]; arm B, 22/23 [95.7%]; arm C, 14/14 [100%]). Arm B was least costly (mean, $9837 ± 1375 per month), arm C was most expensive (mean, $22543 ± 11158 per month), and arm A had an intermediate cost (mean, $14261 ± 1645 per month). Approximately 30% of patients required pegvisomant dose uptitration. Rates of adverse events were all < 10%.
Conclusions
Low-dose SRL plus weekly pegvisomant represents a novel dosing option for achieving cost-effective, optimal biochemical control in patients with uncontrolled acromegaly requiring combination therapy.
Journal Article
Once-Weekly Somapacitan vs Daily GH in Children With GH Deficiency: Results From a Randomized Phase 2 Trial
Abstract
Context
Daily growth hormone (GH) injections can be burdensome for patients and carers. Somapacitan is a long-acting, reversible albumin-binding GH derivative in development for once-weekly administration in patients with growth hormone deficiency (GHD).
Objective
The objective of this study is to evaluate the efficacy, safety, and tolerability of once-weekly somapacitan vs once-daily GH.
Design
REAL 3 is a multicenter, randomized, controlled, double-blind (somapacitan doses), phase 2 study with a 26-week main and 26-week extension phase (NCT02616562).
Setting
This study took place at 29 sites in 11 countries.
Patients
Fifty-nine GH treatment-naive prepubertal children with GHD were randomly assigned; 58 completed the trial.
Interventions
Interventions comprised 3 somapacitan doses (0.04 [n = 16], 0.08 [n = 15], or 0.16 mg/kg/wk [n = 14]) and daily GH (0.034 mg/kg/d [n = 14]), administered subcutaneously.
Main Outcome Measures
The primary end point was height velocity (HV) at week 26. Secondary efficacy end points included HV SD score (SDS) and insulin-like growth factor-I (IGF-I) SDS.
Results
At week 26, mean (SD) annualized HV for the somapacitan groups was 8.0 (2.0), 10.9 (1.9), and 12.9 (3.5) cm/year, respectively, vs 11.4 (3.3) cm/year for daily GH; estimated treatment difference (somapacitan 0.16 mg/kg/week—daily GH): 1.7 [95% CI –0.2 to 3.6] cm/year. HV was sustained at week 52, and significantly greater with somapacitan 0.16 mg/kg/week vs daily GH. Mean (SD) change from baseline in HV SDS at week 52 was 4.72 (2.79), 6.14 (3.36), and 8.60 (3.15) for the somapacitan groups, respectively, vs 7.41 (4.08) for daily GH. Model-derived mean (SD) IGF-I SDS for the somapacitan groups was −1.62 (0.86), −1.09 (0.78), and 0.31 (1.06), respectively, vs −0.40 (1.50) observed for daily GH. Safety and tolerability were consistent with the profile of daily GH.
Conclusions
In children with GHD, once-weekly somapacitan 0.16 mg/kg/week provided the closest efficacy match with similar safety and tolerability to daily GH after 26 and 52 weeks of treatment. A short visual summary of our work is available (1).
Journal Article
The skeletal system
Describes the various parts of the skeleton and how bones grow, and discusses joints, the difference between male and female skeletons, bone injuries and diseases, and related topics.
Book
Growth Hormone plus Childhood Low-Dose Estrogen in Turner's Syndrome
This trial randomly assigned girls 5 to 12.5 years of age with Turner's syndrome to receive growth hormone, low-dose estrogen, neither, or both. Growth hormone increased adult height. Combining ultra-low-dose estrogen with growth hormone during childhood may optimize growth.
Turner's syndrome, which results from partial or complete X-chromosome monosomy, occurs in about 1 in 2000 live female births
1
and encompasses diverse clinical features, including short stature, ovarian dysgenesis, and neurocognitive problems.
2
The marked short stature in Turner's syndrome (an average, untreated adult height 20 cm below that of the general female population
3
,
4
) can be ameliorated by treatment with recombinant human growth hormone. Although there is substantial evidence that growth hormone treatment increases adult stature in patients with Turner's syndrome,
5
–
13
data from randomized, double-blind, placebo-controlled studies have been lacking.
13
Ovarian failure, the second major problem associated with . . .
Journal Article
Ecology for the 99% : twenty capitalist myths debunked
\"If everyone-from Emmanuel Macron to Jeff Bezos, and even Coca Cola-is green, why is the environmental crisis growing at an alarmingly rapid rate? The world is already experiencing the impact of climate crisis, but we are not equally responsible for its violent effects. Some of those who claim to be helping the planet are actually making things worse. To avoid being duped by false allies and to create an ecology for the 99%, we must discuss a radical topic: the exit from capitalism. Ecology for the 99% provides inspiration for building grassroots environmental movements through a lively discussion of the most persistent capitalist myths. It presents compelling evidence for why carbon market policies will fail, why a capitalist economy cannot be based on renewable energy sources, and why we should be protesting against overproduction, not overconsumption. Ecology for the 99% is an antidote to apathy and a bulwark against false leads. Time is running out, we can't afford to take any wrong turns.\"-- Provided by publisher.
BOOK
High-throughput mediation analysis of human proteome and metabolome identifies mediators of post-bariatric surgical diabetes control
To improve the power of mediation in high-throughput studies, here we introduce High-throughput mediation analysis (Hitman), which accounts for direction of mediation and applies empirical Bayesian linear modeling. We apply Hitman in a retrospective, exploratory analysis of the SLIMM-T2D clinical trial in which participants with type 2 diabetes were randomized to Roux-en-Y gastric bypass (RYGB) or nonsurgical diabetes/weight management, and fasting plasma proteome and metabolome were assayed up to 3 years. RYGB caused greater improvement in HbA1c, which was mediated by growth hormone receptor (GHR). GHR’s mediation is more significant than clinical mediators, including BMI. GHR decreases at 3 months postoperatively alongside increased insulin-like growth factor binding proteins IGFBP1/BP2; plasma GH increased at 1 year. Experimental validation indicates (1) hepatic GHR expression decreases in post-bariatric rats; (2) GHR knockdown in primary hepatocytes decreases gluconeogenic gene expression and glucose production. Thus, RYGB may induce resistance to diabetogenic effects of GH signaling.
Trial Registration: Clinicaltrials.gov NCT01073020.
Factors underlying the effects of gastric bypass surgery on glucose homeostasis are incompletely understood. Here the authors developed and applied high-throughput mediation analysis to identify proteome/metabolome mediators of improved glucose homeostasis after to gastric bypass surgery, and report that improved glycemia was mediated by the growth hormone receptor.
Journal Article